ORIGINAL ARTICLE Predictive factors of subjective outcomes aſter septoplasty with and without turbinoplasty: can individual perceptual differences of the air passage be a main factor? Sang Duk Hong, MD, Nak-Joon Lee, MD, Hyun-Jin Cho, MD, Min-Seok Jang, MD, Tae Young Jung, MD, Hyo Yeol Kim, MD, PhD, Seung-Kyu Chung, MD, PhD and Hun-Jong Dhong, MD, PhD Background: Although septoplasty provides adequate cor- rection of septal deviation, patients are not always satisfied with the procedure. The degree of satisfaction aſter sep- tal surgery may be affected by individual differences in the perception of one’s nasal passage changes and emotional factors. The aim of this study is to identify the predictive factors that influence subjective septoplasty outcomes. Methods: Forty-nine patients with septal deviation and nasal obstruction were enrolled. Forty-three patients com- pleted the study 3 months aſter surgery. Age, gender, allergies, smoking, and degree of septal deviation were evaluated. The differences in the visual analogue scale for nasal obstruction and nasal volume measured by acoustic rhinometry between pre-decongestant and post- decongestant states were analyzed. A stress questionnaire (SQ) and Beck’s depression index (BDI) were also used to evaluate the emotional factors. Subjective satisfaction was evaluated as the difference in nasal obstruction symptom evaluation (NOSE) scores between baseline and 3 months postoperation. Results: Subjective satisfaction was not related to indi- vidual perceptual differences in nasal passage changes, depression index, age, gender, allergy status, smoking, or degree of septal deviation (p > 0.05 in all; univariate anal- ysis). The baseline SQ and NOSE scores were significant predictive factors in univariate analysis. However, on multi- ple regression, only the baseline NOSE scores were related to subjective satisfaction aſter septoplasty. Conclusion: Individual perceptual differences of air pas- sage changes and emotional factors do not predict sub- jective symptom improvement aſter septoplasty. Baseline symptoms were the only predictive factor for patient satis- faction aſter septoplasty. C  2015 ARS-AAOA, LLC. Key Words: septoplasty; turbinoplasty; nasal obstruction; predictive factor; satisfaction; acoustic rhinometry How to Cite this Article: Hong SD, Lee NJ, Cho HJ, et al. Predictive factors of subjective outcomes aſter septoplasty with and without turbinoplasty: can individual perceptual differences of the air passage be a main factor? Int Forum Allergy Rhinol. 2015;5:616–621. N asal obstruction is the most common symptom observed in rhinological practice, and septoplasty is the third most common surgery performed by Department of Otorhinolaryngology–Head and Neck Surgery, Samsung Medical CenterSungkyunkwan University School of Medicine, Seoul, South Korea Correspondence to: Hun-Jong Dhong, MD, PhD, Department of Otorhinolaryngology–Head and Neck Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul 135–710, Korea; e-mail: hjdhong@skku.edu S.D.H. and N.J.L. contributed equally to this work. Potential conflict of interest: None provided. Received: 1 October 2014; Revised: 24 December 2014; Accepted: 20 January 2015 DOI: 10.1002/alr.21508 View this article online at wileyonlinelibrary.com. otorhinolaryngologists. 1 However, septal deviation may not always be the cause of nasal obstruction; there are many asymptomatic patients with septal deviation 2 and many others have nasal obstruction without septal deviation. 3 Because there is no reliable objective test to quantify nasal obstruction (unlike hearing or vision loss), clinicians are mainly reliant on subjective measures of satisfaction af- ter nasal surgery. 4 Some patients are not satisfied with the outcome after septoplasty despite successful correction, and this might lead to medicolegal problems. Furthermore, some investigators criticize the number of unnecessary sep- toplasties performed each year. 5 If one could identify which patients will have higher sat- isfaction after surgery, this might help select the most ap- propriate patients for septoplasty. In our experience, some patients report subjective improvement in nasal breathing International Forum of Allergy & Rhinology, Vol. 5, No. 7, July 2015 616